Backström M C, Mäki R, Kuusela A L, Sievänen H, Koivisto A M, Koskinen M, Ikonen R S, Mäki M
Department of Pediatrics, Tampere University Hospital, Finland.
J Pediatr Gastroenterol Nutr. 1999 Nov;29(5):575-82. doi: 10.1097/00005176-199911000-00019.
Although the short-term benefits of mineral supplementation in preterm infants has been established, the long-term benefits are less clear. The purpose of the study was to evaluate effects of early-life mineral, vitamin D, and breast milk intake on bone mineral status in children 9 to 11 years of age who were born prematurely.
Seventy preterm infants born 1985 through 1987 were randomized into four groups: to receive a vitamin D dose of 500 or 1000 IU/day and calcium- and phosphorus-supplemented or unsupplemented breast milk. At 3 months of age, radial bone mineral content was determined by single-photon absorptiometry and vitamin D metabolites were assessed. At 9 to 11 years of age, the bone mineral status of the radius and lumbar spine was assessed using dual energy x-ray absorptiometry.
At the age of 3 months, the preterm infants with diets supplemented with minerals had 36% higher bone mineral content than the preterm infants whose diet was not supplemented with minerals. At the age of 9 to 11 years, in contrast, bone mineral status was comparable among the groups, irrespective of different mineral supplementation during the neonatal period. Interestingly, the lumbar bone mineral apparent density was positively related to lactation in mineral-supplemented children. There was neither short-term nor long-term benefit to bone mineral status of a vitamin D dose of 1000 IU/day compared with 500 IU/day.
The short-term benefit to bone mineral density in preterm infants of mineral supplementation of the early diet is obvious, but, in the long term, the effects seem to disappear. The results also imply that a relatively long period of breast-feeding may be needed to optimize long-term bone mineral acquisition in the lumbar spine.
尽管已证实矿物质补充剂对早产儿有短期益处，但其长期益处尚不清楚。本研究的目的是评估生命早期矿物质、维生素D和母乳摄入量对9至11岁早产儿童骨矿物质状况的影响。
将1985年至1987年出生的70名早产儿随机分为四组：分别接受500或1000国际单位/天的维生素D剂量，以及补充或不补充钙和磷的母乳。在3个月大时，通过单光子吸收法测定桡骨骨矿物质含量，并评估维生素D代谢产物。在9至11岁时，使用双能X线吸收法评估桡骨和腰椎的骨矿物质状况。
在3个月大时，饮食中补充矿物质的早产儿的骨矿物质含量比未补充矿物质的早产儿高36%。相比之下，在9至11岁时，各组之间的骨矿物质状况相当，无论新生儿期矿物质补充情况如何。有趣的是，补充矿物质的儿童腰椎骨矿物质表观密度与哺乳呈正相关。与500国际单位/天的维生素D剂量相比，1000国际单位/天的维生素D剂量对骨矿物质状况既无短期益处也无长期益处。
早期饮食中补充矿物质对早产儿骨矿物质密度的短期益处明显，但从长期来看，这种影响似乎消失了。研究结果还表明，可能需要较长时间的母乳喂养才能优化腰椎的长期骨矿物质获取。
